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Symptoms
By Mayo Clinic staffBoth psoriatic arthritis and psoriasis are chronic diseases that get worse over time, but you may have periods when your symptoms improve or go into remission alternating with times when symptoms become worse. Often, skin and joint problems appear and disappear at the same time.
General signs and symptoms of psoriatic arthritis include:
- Pain in affected joints
- Swollen joints
- Joints that are warm to the touch
Patterns of joint pain in psoriatic arthritis
Doctors have identified five types of psoriatic arthritis, and you may experience several of them over time. They include:
- Pain in joints on one side of your body. The mildest form of psoriatic arthritis, called asymmetric psoriatic arthritis, usually affects joints on only one side of your body or different joints on each side — including those in your hip, knee, ankle or wrist. Fewer than five joints are generally involved, and they're often tender and red. When asymmetric arthritis occurs in your hands and feet, swelling and inflammation in the tendons can cause your fingers and toes to resemble small sausages (dactylitis).
- Pain in joints on both sides of your body. Symmetric psoriatic arthritis usually affects five or more of the same joints on both sides of your body. More women than men have symmetric psoriatic arthritis, and psoriasis associated with this condition tends to be severe.
- Pain in your finger joints. Distal interphalangeal (DIP) joint predominant psoriatic arthritis is rare and occurs mostly in men. This type of arthritis affects the small joints closest to the nails (distal joints) in the fingers and toes. The nails, too, often show classic signs of psoriasis, including thickening, pitting and discoloration.
- Pain in your spine. This form of psoriatic arthritis, called spondylitis, can cause inflammation in your spine as well as stiffness and inflammation in your neck, lower back or sacroiliac joints. Inflammation can also occur where ligaments and tendons attach to your spine. As the disease progresses, movement tends to become increasingly painful and difficult.
- Destructive arthritis. A small percentage of people with psoriatic arthritis have arthritis mutilans — a severe, painful and disabling form of the disease. Over time, arthritis mutilans destroys the small bones in your hands, especially the fingers, leading to permanent deformity and disability.
When to see a doctor
If you have psoriasis, be sure to tell your doctor if you develop joint pain. Psoriatic arthritis can come on suddenly or develop slowly, but in either case it can severely damage your joints if left untreated.
- Questions and answers about psoriasis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/hi/topics/psoriasis/psoriafs.htm. Accessed Sept. 9, 2008.
- Psoriatic arthritis. American College of Rheumatology. http://www.rheumatology.org/public/factsheets/psoriatic_new.asp. Accessed Sept. 9, 2008.
- Psoriasis of the nails. National Psoriasis Foundation. http://www.psoriasis.org/about/psoriasis/sites/nails.php. Accessed Sept. 9, 2008.
- Psoriatic arthritis. National Psoriasis Foundation. http://www.psoriasis.org/about/psa. Accessed Sept. 9, 2008.
- Gordon KB, et al. The treatment of psoriasis and psoriatic arthritis: An interdisciplinary approach. The Journal of the American Academy of Dermatology. 2006;54(3)(suppl):S85-S91.
- Cerhan JR, et al. Antioxidant micronutrients and risk of rheumatoid arthritis in a cohort of older women. American Journal of Epidemiology. 2003;157(4):345-354.
- Imokawa S, et al. Methotrexate pneumonitis: Review of the literature and histopathological findings in nine patients. The European Respiratory Journal. 2000;15(2):373-381.
- Tobin AM, et al. TNF alpha inhibitors in the treatment of psoriasis and psoriatic arthritis. BioDrugs. 2005;19(1):47-57.
- Gladman DD, et al. Patient information: Psoriatic arthritis. http://www.uptodate.com/home/index.html. Accessed Sept. 11, 2008.
